Arteriovenous fistulas ipsilateral to internal jugular catheters for hemodialysis have decreased patency rates

Özpak, Berkan; Yılmaz, Yakup

doi:10.1177/1708538118811483

Cited by 9 publications

(8 citation statements)

References 27 publications

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“…In one previous retrospective study of 322 patients, it was noted that AVF survival was lower in those with ipsilateral TVCs compared with contralateral TVCs, but the primary AVF failure rates were similar (50% vs 53%, P =0.70) (19). In another retrospective study involving 201 patients, the rate of cannulation failure was higher in AVFs that had ipsilateral TVCs (39% vs 11%, P <0.001), whereas the overall AVF survival was longer in the contralateral TVC group (778.7 vs 247.3 days, P <0.002) (9). A third retrospective study of 187 patients, however, showed no difference in assisted (74% vs 64%, P =0.22) and unassisted (62% vs 55%, P =0.41) functional AVF maturation between ipsilateral and contralateral TVC groups (20).…”

Section: Discussionmentioning

confidence: 99%

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Impact of Previous Tunneled Vascular Catheters and their Location on Upper Limb Arteriovenous Fistula Function

et al. 2021

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Background: Long-term Arteriovenous Fistula (AVF) survival has been shown to be adversely impacted by the presence of previous Tunnelled Vascular Catheters (TVC). We analysed the effect of previous TVCs and their location (ipsilateral versus contralateral) on the successful function of upper limb AVFs in the first 12-months after creation. Methods: We retrospectively reviewed clinical data on patient's first upper limb AVFs, created between January 2013 and December 2017. We analysed the rates of successful AVF function (successful cannulation using 2 needles for ≥50% sessions over a 2-week period) at 6- and 12- months post creation, time to AVF maturation, and rates of assisted maturation. Results: 287 patients with first AVFs were identified, of which 142 patients had a previous TVC (102 contralateral, 40 ipsilateral) and 145 had no previous TVC. The No TVC group had higher rate of AVF function at both 6-months (68.6% vs 54.3%, OR 1.84, 95% CI 1.00-3.39, p=0.05) and 12-months (84.3% vs 63.5%, OR 3.10, 95% CI 1.53-6.26, p=0.002) compared to the TVC group. The Contralateral TVC group had higher rate of AVF function at 6-months (59.6% vs 40%, OR 2.21, 95% CI 1.01-4.88, p=0.05), but not at 12-months (65.9% vs 57.6%, OR 1.42, 95% CI 0.62-3.25, p=0.40) compared to the Ipsilateral TVC group. The median time to AVF maturation in the Contralateral and Ipsilateral TVC groups were 121.5 and 146 days respectively (p=0.07). Assisted maturation rates were lower in No TVC group compared to the TVC group (12.4% vs 27.9%, p=0.007), but similar between the Contralateral and Ipsilateral TVC groups (28.7% vs 25.7 %, p= 0.74). Conclusions: Previous TVC use was associated with poorer AVF function at 6- and 12-months, with a higher rate of assisted maturation. The presence of an ipsilateral TVC was associated with lower successful AVF use at 6-months, compared to contralateral TVC.

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Section: Discussionmentioning

confidence: 99%

“…Some retrospective studies have also shown that long-term AVF survival is lower in patients with previous ipsilateral TVC, compared with contralateral TVC (9). However, the effect of an existing TVC and its location on the subsequently formed AVF’s maturation and early function has not been well studied.…”

Section: Introductionmentioning

confidence: 99%

Impact of Previous Tunneled Vascular Catheters and their Location on Upper Limb Arteriovenous Fistula Function

et al. 2021

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“…The finding of an increased risk of AVF failure in patients with a CVC in this study is consistent with that reported in the Dialysis Outcomes and Practice Patterns Study [42][43][44] . This increased risk may be related to potential hemodynamic effects and central vein stenosis associated with ipsilateral catheter placement 45 . In addition, CVC predispose patients to blood stream infection and hospitalization 46 which could indirectly predispose to AVF failure via hypotension and the inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Arteriovenous Fistula Failure: A Post Hoc Analysis of the FAVOURED Study

et al. 2020

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Background An autologous arteriovenous fistula (AVF) is the preferred hemodialysis vascular access but successful creation is hampered by high rates of AVF failure. This study aimed to evaluate patient and surgical factors associated with AVF failure to improve vascular access selection and outcomes. Methods This is a post-hoc analysis of all participants of FAVOURED, a multi-center, double-blind, multinational, randomized placebo-controlled trial evaluating the effect of fish oil and/or aspirin in preventing AVF failure in patients receiving hemodialysis. The primary outcome of AVF failure was a composite of fistula thrombosis and/or abandonment and/or cannulation failure at 12 months post AVF creation and secondary outcomes included individual outcome components. Patient data (demographics, comorbidities, medications and laboratory data) and surgical factors (surgical expertise, anesthetic, intraoperative heparin use) were examined using multivariable logistic regression analyzes to evaluate associations with AVF failure. Results Of 536 participants, 253 patients (47%) experienced AVF failure during the study period. The mean age was 55 ± 14.4 years, 64% were male, 45% were diabetic and 4% had peripheral vascular disease. Factors associated with AVF failure included female sex (odds ratio [OR] 1.79, 95% confidence interval [CI] 1.20-2.68), lower diastolic blood pressure (OR for higher DBP 0.85, 95% CI 0.74-0.99), presence of central venous catheter (OR 1.49, 95% CI 1.02-2.20, p=0.04) and aspirin requirement (OR 1.60, 95% CI 1.00-2.56). Conclusions 3 Female sex, requirement for aspirin therapy, requiring hemodialysis via a central venous catheter and lower diastolic blood pressure were factors associated with higher odds of AVF failure. These associations have potential implications for vascular access planning and warrant further studies.

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“…Responsibility for the information and views expressed herein lies entirely with the author(s). Two needles for $50% of hemodialysis over 2-week period Shingarev et al, 2012 (10) Three consecutive hemodialysis sessions (two needles, dialysis blood flow $250 ml/min) Kim et al, 2019 (11) One successful hemodialysis with both cannula Ozpak and Yilmaz, 2019 (12) Four consecutive dialysis sessions AVF, arteriovenous fistula; KHI, Kidney Health Initiative.…”

Section: Acknowledgmentsmentioning

confidence: 99%

“…Within the TVC group, performance of AVF placed contralateral to TVC was superior to ipsilateral AVF placement, but this effect lost statistical significance by 12 months. Their data suggest that ipsilateral TVC placement is associated with delayed AVF maturation, a divergent finding from previous studies, which showed similar 6-month primary failure rates in these patient groups (10)(11)(12). An important consideration in explaining these differences is the heterogeneity in definitions used when describing successful AVF cannulation or AVF maturation, with Diep et al using the closest definition to the Kidney Health Initiatives' recommendations (Table 2).…”

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confidence: 91%

The Sisyphean Task of Getting the Arteriovenous Fistula to Mature

2021

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Dialysis access literature is full of allegories borrowed from Greek mythology-names of Achilles, Hercules, and Pandora have been used to describe many challenges encountered by nephrologists. Following this tradition, we add the study by Diep et al. to the list of publications dedicated to the disentanglement of factors hindering our efforts to create a perfect vascular access for dialysis-a truly Sisyphean task.Dialysis access failure remains a significant barrier to providing adequate RRT. Autologous arteriovenous fistula (AVF) placement is the preferred access modality for most patients when developing an "ESKD Life Plan," given the well-documented benefits compared with tunneled vascular catheters (TVC), including

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Arteriovenous fistulas ipsilateral to internal jugular catheters for hemodialysis have decreased patency rates

Cited by 9 publications

References 27 publications

Impact of Previous Tunneled Vascular Catheters and their Location on Upper Limb Arteriovenous Fistula Function

Impact of Previous Tunneled Vascular Catheters and their Location on Upper Limb Arteriovenous Fistula Function

Predictors of Arteriovenous Fistula Failure: A Post Hoc Analysis of the FAVOURED Study

The Sisyphean Task of Getting the Arteriovenous Fistula to Mature

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